Personal best

The increase in sports participation in England isn't reaching government targets, yet over seven million people meet the target of three 30-minute sessions of moderate-intensity sport three times a week, and huge numbers of people watch sport. It's obvious that sport plays a big role in many people's lives, including Dr Victor Thompson's. The description on his website of how he competed in the 2006 Ironman Switzerland competition made me want a little lie down: a 2.4-mile swim, a 112-mile bike ride, followed by a marathon. Victor finished the race but came around to find himself in an intensive care unit on a ventilator.

Victor's route to psychology and triathlons started in East Belfast. 'I did a BTEC course in psychology and found the social and applied psychology modules particularly interesting.' It's perhaps a clichéd question to ask, but did his environment affect his interest in psychology? 'I'm sure it did, particularly in social and group psychology. There were obvious divisions in society, and schools could be tribal; you had to be careful where you hung out. I knew people who were directly affected by the Troubles. I worked in the YMCA on community youth clubs and outreach projects.' Given Victor's later specialisation, was he interested in sports at school? 'Not really. I went to a very authoritarian school and I didn't like the way they organised sports or academic life. The school emphasised rugby, and as I was smaller than average, I just didn't like getting crushed by the other players on cold, wet winter days. I preferred more individual pursuits, like cycling, to team games. The sporting world is incredibly diverse, and I chose the activities – outside school mainly – that fitted me best.'

Victor studied psychology at the University of Sheffield. 'Although I knew no one when I arrived in Sheffield, I really enjoyed the course. I think it's good for any student to pursue what they enjoy. Qualifying to practise psychology is a long and arduous road, and you need that genuine interest to maintain motivation for the long run.'

Did you immediately want to study sports psychology? 'I was involved in a lot of sports and worked in US summer camps, so the interest in people and what made them tick was there. But sports psychology was even more of a niche area than it is now. It was my dream job, but at that time it was no more than that as I couldn't see how I'd manage to have an interesting job doing it and manage to pay the rent. Clinical psychology seemed sexy and attractive – what everyone seemed to be pursuing – and very competitive. Yet it also seemed to be a lottery to get into, with very similarly talented and experienced graduates competing for a limited number of places. I wasn't sure I wanted to go down that route. But I was absolutely sure I wanted to do something practical not just academic.'

So it seems strange that his first job was as a research assistant. 'Following on from my degree I was keen to get some, or any, kind of hands-on experience in a clinical or research field that would help me explore the potential of clinical psychology. I was fortunate enough to gain some initial experience with Professor Glenys Parry, the then Head of the Clinical Psychology Service in Sheffield and the first psychologist to work on mental health policy with the Department of Health. But her present job as a Professor of Applied Psychological Therapies at Sheffield gives a clue as to why I found the work so rewarding. Glenys is very talented and very down-to-earth. For three years I continued to gain more and more relevant clinical and research experience for clinical psychology. I worked with adults and children, in regular mental health settings, drugs and alcohol, sexual health and chronic pain. For the last fifteen months of this I worked in the R&D Department, again with Glenys, supporting any member of staff involved in doing or using research. This reinforced the fact that it was working with people that was rewarding, not working on abstract ideas in some isolated lab.'

During this period Victor started to compete in triathlons and took a diploma in sports psychology. 'But I still wasn't sure that was the right route for me. At the time sports psychology didn't seem to be a profession that offered a variety of jobs outside academia. It hadn't reached the stage it has now, where sports psychologists work with teams and individuals.'

In 1998 he went to UCL to study clinical psychology. 'It was still a lottery to get into and Plan B was to pursue research opportunities while I formed my sports psychology – or other – plans further. But I got on the course and enjoyed it hugely: it pushed me professionally and personally. Clinical training gives you a generalist skills set: you learn basic techniques, knowledge and approaches that you can apply to different populations. You're given the opportunity to work with many different sorts of people and I particularly enjoyed working in primary care and hospital-based clinical health psychology. I was intrigued by health issues that lead to psychological difficulties for some people, or how pre-existing psychological difficulties or styles then affect their physical health condition.'

After his clinical course, Victor travelled widely and describes his Australian stay as among the most memorable experiences of his life. 'I met an Aboriginal artist and watched him paint a scene from his homeland. Then a few days later I was invited to spend Christmas on the beach with him and his family. I watched his sister paint for 14 hours straight on Boxing Day, creating one work. This now hangs on my wall as a special memento. Travelling can open us up to experiences with very different communities and ways of living. But essentially, we are all the same and can have a lot of common ground if you are only open enough to find it.'

When he came back Victor needed a job in clinical psychology to consolidate his training and to pay off the travel debt, but: 'I also wanted to learn to approach sports psychology in a way that fitted for me. At the time it seemed to me it didn't always deliver down-to-earth, but effective interventions based on science and practical experience. There was lots of information around about how to improve your performance but less about how to apply it in a straightforward but believable way. I'd been doing triathlons for six years so I had a good experiential base for developing my own skills, understanding clients and rethinking the discipline.'

Is there an element of 'Physician heal thyself' in Victor's own sporting activities? He laughs. 'Not really. As you've seen, triathlon is very taxing, but I'm not frenetic or addicted to it. I don't have the need, as some people do, to exercise obsessively. Which is a very good example of how I view psychology's – all psychology's – contribution to sport and exercise. Exercise addiction or obsessiveness is there for a reason. So, you need to start from that viewpoint and ask "What keeps the habit going, caused it to develop in the first place and what might help to change it?". Psychologists help people to think about their thinking, motives and behaviour, then to experiment with doing things differently.'

Victor picked up where he left off at the end of training in clinical psychology. 'I took up a permanent position which I still hold. I work four days a week in a primary care psychology service, which leaves one day, some evenings and weekend time to work in sport. I have consulting rooms, but I do a lot of my work over the phone. This is obviously unusual since most psychology is done in face-to-face sessions over a moderate to extended period. But a motivated athlete, or an amateur juggling a job and sport, rarely has much spare time in their busy schedule. Elite athletes can be training or competing abroad. That you can achieve something concrete while fitting in with their priorities is an initial test of whether they want to use you. I probably don't ever see a third of my clients, and many of my consultations are carried out over only two or three phone calls. For instance, I might do a phone consultation with a rider who has fallen off her horse. The horse just won't trust its master who is nervous and tense. The horse senses that something is wrong. That issue has been addressed by phone. I prefer to meet people in person; but if that's impossible, the telephone can work effectively too.'

Are the two jobs – in primary care and in sports psychology – very different? 'Yes and no. I'm trying to help people in both. Both require me to use many of the same skills and knowledge to address different problems. Both are about performance – whether you are overcoming setbacks in sport or setbacks in your personal life – and as a consequence improving confidence, mood and enjoyment. We should never forget that latter point. My approach to both areas is quite structured. I assess, formulate the difficulty, then translate a solution into ideas which the individual client will understand. I usually use a whiteboard to go through this process. I use CBT a lot, and I'm careful not to pathologise the client when I'm using clinical skills.'

Where does this slightly dual career lead? 'I like variety. I'm constantly getting asked to get involved in long-term projects with clubs and associations, and by taking up these it will reduce the variety of things I do. In the medium term, I'd like to split my time half and half between clinical and sports work. I suppose three things might affect this. I am increasingly requested to talk to the media, and I'm quite interested in developing this. I'm listed on the Society media list, and the opportunities that come up usually have short turnaround times. Just like for a professional sportsperson, working for the media brings with it performance pressure and the potential for public scrutiny.

'Secondly, the NHS has changed and is becoming more focused on form-filling and less about seeing patients and delivering excellence. That's demotivating for staff, and I'm not convinced that it is that helpful for many patients.

'Finally, I do work with groups other than sports people. There is potential to extend the approach to other groups where performance under pressure is important. Dancers are an obvious example, but you can apply the ideas to others in the performing arts. Also, I've been asked to help city traders to improve their self-management of performance anxiety and to focus on the important elements of their work. Now it interests me to help figure out how psychology can help these client groups. So, I expect the next few years will see some changes – where I'll end up is less certain.'